Περίληψη:
Background: We investigated whether mean heart rate (HR24) and blood
pressure (BP) parameters during 24-h ambulatory BP monitoring (ABP) are
independent or additive markers of left ventricular (LV) mass in
subjects with newly diagnosed, untreated hypertension.
Methods: A total of 250 patients (40% women, 60% men; mean age 59.6
+/- 11 years) with essential hypertension who were attending the
outpatient Hypertension Unit were studied. All patients underwent 24-h
ABP and HR monitoring as well as echocardiography for assessment of left
ventricular (LV) dimensions and function.
Results: A decreasing HR24 or increasing ABP parameters (ie, systolic,
diastolic, mean BP, and pulse pressure) were associated with increasing
LV mass (P <.001) and wall thickness (P <.01). In multivariate analysis,
after adjusting for age, gender, body surface area, body mass index,
hematocrit, glucose, cholesterol, smoking, and each of the measured ABP
parameters separately, decreasing HR24 was independently related to
increasing LV mass in addition to ABP and body size parameters (P
<.001). The addition of HR24 in different multivariate models for
prediction of LV mass significantly increased the adjusted model r(2)
(range of r(2) change: 0.039 to 0.064, P for change <.05). Decreasing
HR24 or HR during daytime (6 AM to 10 Pm) was associated with a higher
likelihood of LV hypertrophy in addition to ABP parameters (adjusted
odds ratio 0.92 (CI 0.87 to 0.98), per 1 beat/min greater HR24 P =.002
and 0.93 (CI: 0.87 to 0.98), per 1 beat/min greater HR in the daytime P
=.017).
Conclusion: The 24-h HR and BP during ABP are independent and additive
markers of increased LV mass in untreated hypertensive individuals.
Συγγραφείς:
Zakopoulos, NA
Ikonomidis, I
Vemmos, KN
Manios, E and
Spiliopoulou, I
Tsivgoulis, G
Spengos, K
Psaltopoulou, D and
Mavrikakis, M
Moulopoulos, SD
